CMS Formulary

Displaying 51731-51740 of 1611142 results.
ID: 51731
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1988324
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51732
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1988330
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51733
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 1649401
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51734
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 2054979
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 51735
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 2054983
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 51736
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 2055016
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 360
Qty Limit Days: 30
ID: 51737
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 2055014
NDC:
Tier Level: 5
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 51738
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 197701
NDC:
Tier Level: 2
Qty Limit?: 1
Qty Limit Amt: 0
Qty Limit Days: 0
ID: 51739
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 310433
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 180
Qty Limit Days: 30
ID: 51740
Formulary ID: 00021017
Formulary Version: 14
Contract Year: 2021
RXCUI: 310434
NDC:
Tier Level: 2
Qty Limit?: 0
Qty Limit Amt: 120
Qty Limit Days: 30